Volume 14, Issue 3 (8-2026)
J Surg Trauma 2026, 14(3): 144-150 |
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Ethics code: IR.BUMS.REC.1402.378
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Asghari M, Aliabadi I. Diagnostic Value of Clinical Symptoms in Chronic Sinusitis and Their Concordance with CT Scan Findings in Patients Undergoing Functional Endoscopic Sinus Surgery. J Surg Trauma 2026; 14 (3) :144-150
URL: http://jsurgery.bums.ac.ir/article-1-511-en.html
URL: http://jsurgery.bums.ac.ir/article-1-511-en.html
1 Department of Otorhinolaryngology–Head and Neck Surgery, School of Medicine, Razi Specialized Hospital, Birjand University of Medical Sciences, Birjand, Iran
Abstract: (272 Views)
Introduction: Establishing accurate clinical diagnostic criteria is essential for improving bedside diagnosis and appropriate patient selection for computed tomography (CT) imaging. This study evaluated the diagnostic value of clinical symptoms in chronic sinusitis and their concordance with CT findings (Lund-Mackay score) in patients undergoing functional endoscopic sinus surgery (FESS).
Methods: A cross-sectional study was conducted on 206 patients referred for paranasal sinus CT due to suspected chronic sinusitis who subsequently underwent surgery. Clinical symptoms, including nasal congestion, postnasal drip, facial pain, headache, and sleep disturbances, were recorded. CT scans were assessed using the Lund-Mackay scoring system. Diagnostic accuracy indices, including sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratios, were calculated using CT findings as the reference standard.
Results: Chi-square analysis showed a significant association between CT findings and smoking status (P = 0.01). CT findings were also significantly associated with postnasal drip (P = 0.004). Nasal discharge had a sensitivity of 53.2% and specificity of 58.9%. Postpharyngeal drip showed a sensitivity of 37.8% and specificity of 42.1%. Nasal congestion demonstrated a sensitivity of 66.67% and specificity of 29.47%. The sensitivity and specificity of a history of headache were 47.75% and 53.68%, respectively. Sleep disturbances showed a sensitivity of 47.7% and specificity of 62.1%.
Conclusion: Although certain clinical symptoms, particularly postnasal drip, show significant concordance with CT findings in patients undergoing FESS, other symptoms have limited diagnostic value for predicting radiological sinusitis severity. Therefore, clinical symptoms alone are insufficient, and CT imaging remains essential for accurate preoperative evaluation and surgical planning.
Key words: Chronic sinusitis, Clinical diagnosis, CT scan, Sensitivity, Specificity
Methods: A cross-sectional study was conducted on 206 patients referred for paranasal sinus CT due to suspected chronic sinusitis who subsequently underwent surgery. Clinical symptoms, including nasal congestion, postnasal drip, facial pain, headache, and sleep disturbances, were recorded. CT scans were assessed using the Lund-Mackay scoring system. Diagnostic accuracy indices, including sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratios, were calculated using CT findings as the reference standard.
Results: Chi-square analysis showed a significant association between CT findings and smoking status (P = 0.01). CT findings were also significantly associated with postnasal drip (P = 0.004). Nasal discharge had a sensitivity of 53.2% and specificity of 58.9%. Postpharyngeal drip showed a sensitivity of 37.8% and specificity of 42.1%. Nasal congestion demonstrated a sensitivity of 66.67% and specificity of 29.47%. The sensitivity and specificity of a history of headache were 47.75% and 53.68%, respectively. Sleep disturbances showed a sensitivity of 47.7% and specificity of 62.1%.
Conclusion: Although certain clinical symptoms, particularly postnasal drip, show significant concordance with CT findings in patients undergoing FESS, other symptoms have limited diagnostic value for predicting radiological sinusitis severity. Therefore, clinical symptoms alone are insufficient, and CT imaging remains essential for accurate preoperative evaluation and surgical planning.
Key words: Chronic sinusitis, Clinical diagnosis, CT scan, Sensitivity, Specificity
Type of Study: Research |
Subject:
Otolaryngology_ENT
Received: 2025/09/8 | Accepted: 2026/04/28 | ePublished ahead of print: 2026/07/11 | Published: 2026/08/1
Received: 2025/09/8 | Accepted: 2026/04/28 | ePublished ahead of print: 2026/07/11 | Published: 2026/08/1
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